• Processes billing to patients and third-party insurance companies.
• Maintains supporting documentation files and current patient addresses.
• Researches and responds by telephone and / or in writing to patient inquiries regarding billing issues and problems.
• Monitors submitted claims, follows up on unpaid claims, and initiates dialogue with insurance companies.
• Monitors insurance balances at 90-day, 120-day, and 180-day intervals.
• Prepare monthly A/R report for CFO review.
• Submit prior authorization forms to insurance companies.
• Resubmits claims to insurance companies as necessary.
• Performs a variety of general clerical duties, including telephone reception, mail distribution, and other routine functions.
• Answers questions from patients, clerical staff and insurance companies.
• Identifies and resolves patient billing complaints.
• Evaluates patient’s financial status and establishes budget payment plans.
• Follows and reports status of delinquent accounts.
• Performs various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers.
• Works in conjunction with the reception to ensure accurate billing.
• Oversee day-to-day billing team operations.
• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
• Performs miscellaneous job-related duties as assigned.
THE HEALING SANCTUARY
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Certified Medical Coder/Billing Specialist
Summary
The medical billing specialist performs complex clerical and accounting functions for patient billing, including verification of invoice information, maintenance of third-party billing records, and resolution of problems. Follows up on submitted claims and patient billing; resubmits claims or correct inaccuracies. May handle cash items and accounts receivable posting. Works with others in a team environment.
Knowledge, Skills, and Abilities
• Ability to arrange information or actions in a certain order or pattern
• Ability to apply general rules to specific problems to produce reasonable answers
• Ability to communicate effectively both verbally and in writing
• Ability to work as part of a group or team to accomplish a common goal
• Excellent organizational skills
• Proficient in ICD – 10 Codes
• Attention to detail
• CPC (Certified Professional Coder) Certification
• Two years of experience in billing
• Prior experience working in a Medical Office
• Prior experience working in the Insurance Industry
• Prior experience working with Advanced MD or other EMR system
Work Environment and Physical Requirements
Employees work indoors and are protected from weather and/or contaminants, but not, necessarily, occasional temperature changes. The employee is regularly required to sit and often uses repetitive hand motions.
This position description indicates the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to the position.
Medical Doctor/Doctor of Osteopathic Medicine (MD/DO)
Summary
A medical provider who diagnoses and provides nonsurgical treatment for a wide range of diseases and injuries. Serves as a Primary Care Provider to evaluate, treat, and deliver comprehensive, preventive, and wellness-oriented care to patients of all ages. Performs annual wellness visits, well-child checks, work and sports-related physicals. Participate and comply with ACO requirements such as care coordination with specialty Physicians and Providers and facilitate quality care gaps and preventative services. In addition to conventional primary care, this role emphasizes integrative and holistic treatment modalities including: lifestyle medicine, chronic disease management, and coordination with complementary health providers.
- Manage and treat common health problems as well as serious, chronic, and complex illnesses
- Analyze records, reports, test results, or examination information to diagnose medical condition of the patient
- Prescribe or administer medication, therapy, and other specialized medical care to treat or prevent illness, disease, or injury
- Explain procedures and discuss test results or prescribed treatments with patients
- Advise patients concerning diet, activity, hygiene, and disease prevention
- Make diagnoses when different illnesses occur together or in situations where the diagnosis may be obscure
- Monitor patients’ conditions and progress and reevaluate treatments as necessary
- Refer patient to medical specialists or other practitioners when necessary.
- Collect, record, and maintain patient information, such as medical history, reports, or examination results
- Direct and coordinate activities of nurses, assistants, specialists, therapists, and other medical staff
Knowledge, Skills, and Abilities
- Knowledge of the information and techniques needed to diagnose and treat human injuries, diseases, and deformities. This includes symptoms, treatment alternatives, drug properties and interactions, and preventive healthcare measures.
- Ability to identify complex problems and review related information to evaluate options and implement solutions.
- Ability to communicate effectively both verbally and in writing.
- Medical Doctor (MD or DO)
- Maintain current Idaho licensure, Federal DEA and IBOP Certifications. Maintain Board Certification
- Maintain current BLS, ACLS, and PALS Certifications
- Two years of experience working independently in a primary care, urgent care, emergency care, or integrative care setting.
• Bilingual - Spanish
Work Environment and Physical Requirements
Employees work indoors and are protected from weather and/or contaminants, but not, necessarily, occasional temperature changes. The employee is required to sit, stand, walk, climb stairs, and regularly use repetitive hand motions.
This position indicates the general nature and level of work performed by employees within this classification. It is not designed to be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to the position.
Medical Assistant
Summary
A medical assistant performs administrative and certain clinical duties under the direction of a physician. Administrative duties may include scheduling appointments and maintaining medical records. Clinical duties may include taking and recording vital signs and medical histories, preparing patients for examination and administration of investigative protocol. Must maintain a high degree of attention to detail and accurate records. Must provide good customer service in all forms of patient interaction. Must follow established protocols and procedures with exactness and precision.
• Processes billing to patients and third-party insurance companies.
• Maintains supporting documentation files and current patient addresses.
• Researches and responds by telephone and / or in writing to patient inquiries regarding billing issues and problems.
• Monitors submitted claims, follows up on unpaid claims, and initiates dialogue with insurance companies.
• Monitors insurance balances at 90-day, 120-day, and 180-day intervals.
• Prepare monthly A/R report for CFO review.
• Submit prior authorization forms to insurance companies.
• Resubmits claims to insurance companies as necessary.
• Performs a variety of general clerical duties, including telephone reception, mail distribution, and other routine functions.
• Answers questions from patients, clerical staff and insurance companies.
• Identifies and resolves patient billing complaints.
• Evaluates patient’s financial status and establishes budget payment plans.
• Follows and reports status of delinquent accounts.
• Performs various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers.
• Works in conjunction with the reception to ensure accurate billing.
• Oversee day-to-day billing team operations.
• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
• Performs miscellaneous job-related duties as assigned.
Knowledge, Skills, and Abilities
- Ability to communicate effectively both verbally and in writing
- Ability to work as part of a group or team to accomplish a common goal
- Knowledge of principles and processes for providing customer and personal services
- Knowledge of administrative and office procedures and systems
- High School Diploma or equivalent
- Current BLS Certification
- One year of experience in a medical office or clinical environment
- Medical Assistant Certification
- Bilingual - Spanish
Work Environment and Physical Requirements
Employees work indoors and are protected from weather and/or contaminants, but not, necessarily, occasional temperature changes. The employee is required to sit, stand, walk, climb stairs, and regularly use repetitive hand motions.
This position indicates the general nature and level of work performed by employees within this classification. It is not designed to be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to the position.